Breast feeding as birth control

When breastfeeding is used as a method of birth control, it is referred to as the lactational amenorrhea method (LAM). LAM can be used as soon as the baby is born. It can feel a little unfamiliar in the beginning, however, most hospitals have people who can help you. When used correctly, LAM is 98% effective as a contraceptive if these 3 conditions are met.

The baby must be under 6 months of age. After your child is 6 months old, the chances of you getting pregnant is much higher and another method of contraception is needed to avoid pregnancy.
The baby needs to be breastfed purely using your breastmilk. Breastfeeding needs to be maintained during the day and night. There should be no long intervals between feedings. The baby should be breastfed every 4 hours during the day and every 6 hours during the night.
You must not have started your periods again. If this is the case other forms of contraception is needed. Even with all these conditions being met, doctors do recommend other forms of contraception be used.

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Even if your period has not restarted and you have been breastfeeding exclusively for 6 months, it is still possible to get pregnant before your first period. This can happen because women ovulate (when an ovary releases an egg) before they get their period.

LAM doesn’t work if you use a breast pump - you need to nurse your baby. When the baby suckles, it stimulates the production of a hormone that suppresses ovulation. This is why it is essential to supply all your baby’s suckling needs, including comfort suckling. Hence it is imperative not to give the baby a bottle or a dummy.

For women who have lower levels of progesterone than others in the months following giving birth, they are more likely to become fertile earlier. On average, breastfeeding women restart their period after 28 weeks following giving birth. However, periods can return between 15 to 48 weeks post birth.

It is important to remember that breastfeeding can only be used as contraception for the first 6 months of the baby’s life or until your period starts again. After 6 months, this form of contraception becomes less effective. This is especially the case when the baby starts eating solid foods and sleeps for longer. Hence, after 6 months, another form of contraception should be used.

LAM benefits

To the parents:

Natural birth control method
Starts working as soon as you start breastfeeding
Easy, safe and free
Don’t need a prescription
Doesn’t interrupt sex
Reduces bleeding after delivery
Breastfeeding can reduce the chances of getting breast cancer

To the baby:

Breastmilk is the best source of nutrition for the baby
Breast milk contains beneficial antibodies that gives your baby protection against certain infections
Breastfeeding can enhance the bond between you and your baby as it increases body contact and can help soothe your baby
Breastfeeding decreases the risk of your babe consuming germs present in water, formula or other liquids.

Drawbacks

For the mother:

Only prevents pregnancy for up to 6 months
Must breastfeed very regularly and exclusively
Takes a lot of time and energy
Strong nursing relationship - the baby needs to be really good as suckling
Breastfeeding can lower vaginal lubrication when getting aroused which can make sex uncomfortable
Doesn’t protect against STDs

Breastfeeding and Birth Control

There are many safe and effective forms of birth control that can be taken while breastfeeding. Contraception methods include:

Progestin only birth control pills. The combined birth control (estrogen-progestin) pills are not recommended in early breastfeeding as they may reduce milk supply.
The shot which does not affect milk production
Condoms, diaphragms, cervical cap
The intrauterine device (IUD) - last for several years after insertion
Implant - last for several years after insertion

Non-hormonal birth control is safe to use as soon as giving birth. For the first 3 week after giving birth, do not use contraception containing estrogen. After 3 week, these birth control methods can be started.

Breastfeeding is very effective as a birth control method, but only for the first 6 months after the baby’s birth. There are also many other contraception methods that are safe while breastfeeding, so don't worry, and keep yourself protected.

References

"Breastfeeding as Birth Control | Information About LAM", in Plannedparenthood.org, , 2020, <https://www.plannedparenthood.org/learn/birth-control/breastfeeding> [accessed 27 February 2020].
"Breastfeeding as Birth Control", in HealthLink BC, , 2020, <https://www.healthlinkbc.ca/health-topics/hw131799> [accessed 27 February 2020].
"How safe is breastfeeding as a form of birth control?", in BabyCentre UK, , 2020, <https://www.babycentre.co.uk/x543046/how-safe-is-breastfeeding-as-a-form-of-birth-control> [accessed 27 February 2020].